英検１級レベル　長文問題１　Healthcare Spending and Public Health Outcomes

Throughout the latter half of the 20th century, developed nations increasingly recognized the importance of public healthcare systems in enhancing citizens’ overall well-being. Governments expanded healthcare funding, assuming that greater financial investment would lead to improved public health outcomes. However, researchers have debated the extent to which healthcare spending alone determines health indicators such as life expectancy, infant mortality rates, and chronic disease prevalence.

One of the most comprehensive studies on this issue was conducted by the World Health Organization (WHO) in the early 2000s. The research analyzed data from over 190 countries and concluded that while per capita healthcare expenditure is a significant factor in determining health outcomes, it is far from the only one. The study revealed that nations with similar levels of healthcare spending often exhibited stark differences in public health indicators, suggesting that systemic inefficiencies, social determinants, and government policies play equally crucial roles.

For instance, the United States has consistently spent more per capita on healthcare than any other nation, yet its life expectancy lags behind that of many other high-income countries. In contrast, Japan, which allocates significantly less per capita to healthcare, boasts one of the highest life expectancies globally. Experts attribute this discrepancy to differences in diet, social cohesion, and preventive care measures, rather than solely to variations in healthcare funding.

Further analysis has shown that in many cases, the way healthcare funds are allocated is more critical than the total amount spent. Countries that prioritize preventive care and early intervention tend to achieve better health outcomes compared to those that primarily focus on treatment after the onset of illness. The Scandinavian model, for example, emphasizes universal access to primary care, regular health screenings, and comprehensive maternal health services. As a result, these nations report lower rates of preventable diseases and lower overall healthcare costs in the long term.

More recent studies support the idea that health outcomes are also deeply influenced by socioeconomic factors such as education, income inequality, and environmental conditions. Research from institutions such as Harvard and Oxford has demonstrated that individuals with higher levels of education tend to make healthier lifestyle choices, leading to lower rates of obesity, smoking, and chronic illnesses. Moreover, income disparities have been linked to differential access to healthcare services, with marginalized populations often facing barriers to obtaining timely medical attention.

Given these findings, policymakers and health economists argue that simply increasing healthcare spending without addressing underlying social determinants is unlikely to produce substantial improvements in public health. Instead, experts advocate for a multifaceted approach that includes not only equitable healthcare funding but also initiatives aimed at reducing poverty, improving education, and promoting healthier living environments. In this light, the conversation surrounding public health funding has shifted from a debate over financial resources to a broader discussion on systemic reforms necessary to ensure long-term well-being for all citizens.

1. stark /stɑːrk/
Register: Formal/Literary
Meaning: clear, complete, severe
Context: “nations with similar levels of healthcare spending often exhibited stark differences”

6. comprehensive /ˌkɒmprɪˈhensɪv/
Register: Academic/Formal
Meaning: complete, including all aspects
Context: “One of the most comprehensive studies”

(1) According to the WHO study in the early 2000s, what was one major conclusion about healthcare spending?

Correct Answer: 3. Nations with similar healthcare budgets often showed significant differences in health indicators.

Explanation:
本文では、WHOの研究について「nations with similar levels of healthcare spending often exhibited stark differences in public health indicators」と述べています。これは、単に医療費を増やせば健康指標が向上するわけではなく、他の要因も重要であることを示唆しています。

選択肢の検討:

• 1. 誤り：「Countries that spent more on healthcare always had better public health outcomes」
  → 本文では、「必ずしも良い健康指標を示さない」と述べられているため、不正解。
• 2. 誤り：「Healthcare spending was the sole determining factor in life expectancy」
  → WHOの研究は、医療費だけが健康に影響するわけではないと結論づけているため不正解。
• 4. 誤り：「The United States’ high healthcare spending resulted in superior public health outcomes compared to other countries」
  → アメリカの医療支出は世界最大だが、健康指標は他の先進国より劣ると述べられているため不正解。

 

 

(2) What is one point made about the United States in the passage?

Correct Answer: 2. Despite high healthcare expenditures, its public health outcomes are not the best.

Explanation:
本文では、「The United States has consistently spent more per capita on healthcare than any other nation, yet its life expectancy lags behind that of many other high-income countries」と述べられています。これは、「アメリカは多くの医療費を使っているが、健康指標は最良ではない」という主張と一致します。

選択肢の検討:

• 1. 誤り：「Its healthcare system is highly efficient, leading to the highest life expectancy in the world」
  → 本文ではアメリカの医療制度の効率が悪く、健康指標が低いと述べられているため、不正解。
• 3. 誤り：「Its reliance on preventive care has minimized chronic disease prevalence」
  → アメリカは予防医療より治療に重点を置いているため、この記述は本文と矛盾する。
• 4. 誤り：「The federal government has completely eliminated healthcare inequalities」
  → 依然として医療の不平等が存在すると本文で述べられているため、不正解。

 

 

(3) What is implied about public health strategies in the passage?

Correct Answer: 1. Countries that focus on preventive care tend to achieve better health outcomes.

Explanation:
本文では、「Countries that prioritize preventive care and early intervention tend to achieve better health outcomes」と述べられており、これに最も近い選択肢は 1 です。

選択肢の検討:

• 2. 誤り：「Increasing healthcare funding always leads to significant improvements in public health」
  → 医療費の増加が必ずしも健康改善につながるとは限らないと本文で述べられているため、不正解。
• 3. 誤り：「Education and income levels have little impact on overall health」
  → 本文では、教育水準や所得水準が健康に大きく影響すると述べているため、不正解。
• 4. 誤り：「Standardized test scores can predict the quality of a nation’s healthcare system」
  → 標準化されたテストのスコアが医療制度の質を予測するという記述は本文にはないため、不正解。

 

 

(4) Which of the following best summarizes the relationship between healthcare spending and public health outcomes?

Correct Answer: 2. Socioeconomic factors and healthcare allocation strategies play a crucial role in health outcomes.

Explanation:
本文では、「while per capita healthcare expenditure is a significant factor in determining health outcomes, it is far from the only one」と述べられており、健康指標には社会経済的要因や医療資源の配分が大きな役割を果たすことが示されています。

選択肢の検討:

• 1. 誤り：「Increased spending always results in higher life expectancy and lower disease rates」
  → 本文では、単に医療費を増やしても健康指標が向上するわけではないと述べているため、不正解。
• 3. 誤り：「Nations that invest heavily in treatment rather than prevention tend to have the best results」
  → 本文では、予防医療を重視する国の方が良い健康指標を示すと述べられているため、不正解。
• 4. 誤り：「The effectiveness of healthcare spending cannot be measured due to the complexity of health indicators」
  → 本文では、データ分析によって医療費の影響がある程度測定できると示唆されているため、不正解。